passmed 16/05 Flashcards
Cerebral palsy how to manage pain and spasticity in legs?
oral diazepam
baclofen - muscle relaxant
inhibits release of excitatory neurotransmitters
spastic cerebral palsy where is the lesion?
UMN
spastic: hemiplegia, diplegia /quadriplegia
increase tone
athetoid movements and oro-motor problems - lip smacking etc is?
dyskinetic cerebral palsy
> damage to basal ganglia and substantia nigra
cerebereller signs in CP
ataxic
cerebellum damaged
how can you manage spasticity?
oral diazepam
intrathecal baclofem
botulinum toxin type a
orthopaedic surgery
tet of fallot what signifies severity?
degree of pulmonary stenosis
whichh is the right ventricular outflow obstruction determining cyanosis
TOF 4 defects are?
ventricular septal defect
right ventricular hypertrophy
right ventricular outflow obstruction(pulmonary stenosis)
overriding aorta
ebstein anomaly
tricuspid valve leaflets are attached to walls of and septum of right ventricle
lithium use in first trimester is risk fcator
characteristics of nephrotic syndrome?
proteinuria
hypoalbuminaemia
oedema
hyperlipidaemia
hypercoagulable state
predisposition to infection
continuous machinery murmur?
PDA
do innocent murmurs vary with position?
YES
if patient has a pulse of 30 bpm
do you start CPR?
if unconscious
yes
15 chest compression to 2 breaths
croup is caused by ?
what does it sound like?
management?
parainfluenza virus
barking cough - inspiratory stridor
give dexamethosone and if anything other than mild admit
intense paroxysmal cough followed by loud high pitched whopping sound?
hwo to manage?
whooping cough caused by bordetella pertussis
macrolide - 10 days
pyloric stenosis is the vomit bilious?
no it is not as it is from stomach - dummy
but meconium ileus > cystic fibrosis does have green vomit because it is small bowel obstruction
investigate : pyloric stenosis?
abg results?
management?
abdo uss
hypocholraemic hypokalaemia alkalosis
ramstedt pyloromyotomy
what is expressivity?
difficult to predict likely impact as genotype affceting phenotypic expression is variable
what is in the 6 in 1
diphtheria
tet
pertussis
polio
haemophilus
hep B
severe croup how do you manage?
supplemental oxygen - and
nebulised adrenaline - vasoconstrict of upper airway
reduces airway edema and improves airflow
laryngomalacia
Congenital abnormality of the larynx.
Infants typical present at 4 weeks of age with:
stridor
Plagiocephaly
Plagiocephaly is a skull deformity producing unilateral occipital flattening, which pushes the ipsilateral forehead ear forwards producing a ‘parrallelogram’ appearance. The vast majority improve by age 3-5 due to the adoption of a more upright posture
what scan for stable meckles diverticulum?
technetium scan
technetium-99m pertechnetate scan
what does a positive raised level of immunoreactive trypsinogen mean?
CF suspicios do sweat test
is a pancreatic enzyme release when there is damage to pamcreas
hand foot and mouth disease is caused by?
coxsackie a16 virus
fine punctate erythema sparing the area around the mouth
scarlet fever rahs
erythrpgenic toxin from alpha haemolytic streptococci
fifth disease?
slapped cheek syndrome
parovirus b19
what has a prodrom of fever, conjunctivits and fever?
rubella or measles?
measles
rubella pink maculopapular rash first presents on face then spreads
DMSA (dimercaptosuccinic acid) scan
is a type of nuclear medicine imaging test that evaluates
identify kidney damage or scarring t
west syndrome?
infantile spasm /colic looking
childhood epilepsy - serious
EEg abnormal
vigabtrin 1st line
simple febrile convulsion
tonic clonic
focus of infection
<15 minutes
no reoccurence in 24 hours
Steroid therapy should be given to all children who have an asthma attack
salbutamol inhaler and 3 days prednisolone
what is a common complication of chickenpox?
secondary bacterial infection
NSAIds can complicate this
invasive group A streptococcal soft tissue sinfection = nectrosing fascitis
what WCC would suggest septic arthritis?
ESR >40
WCC>12
how to manage hypospadias?
surgical correction using foreskin remnants
congenital diaphragmatic hernia
The presence of the liver in the thoracic cavity is a poor prognostic factor for CDH
